Oncologists are praising the surgeon general's recommendation to add cancer-risk warning labels to alcohol.
A Jan. 3 report from U.S. Surgeon General Vivek Murthy, MD, found that alcohol consumption contributes to about 100,000 cancer cases and 20,000 cancer deaths each year. The causal link between alcohol and cancer was established in the 1980s, and Dr. Murthy's advisory said there are at least seven alcohol-related cancers: cancer of the breast (in women), colorectal, esophageal, liver, mouth (oral cavity), throat (pharynx) and voice box (laryngeal).
However, fewer than half of Americans are aware of the cancer risk.
To improve awareness, Dr. Murthy recommended updating the health warning on alcoholic beverage labels to be more visible and prominent, informing patients in clinical settings about the risk and creating alcohol reduction strategies in population-level cancer prevention initiatives. He also called for HHS to reassess the recommended limits for alcohol consumption, which currently stands at two drinks or fewer for men and one drink or fewer for women per day.
Oncologists and researchers from top U.S. cancer centers shared their insights on the recommendations with Becker's:
Note: Answers have been lightly edited for clarity and brevity.
Marcel van den Brink, MD, PhD. President and Chief Physician Executive at City of Hope Los Angeles and City of Hope National Medical Center (Duarte, Calif.): These new findings regarding the cancer risk of even small amounts of alcohol have similarities with the initial studies regarding the cancer risk of smoking, which led people to smoke less and dramatically decreased lung cancer in the United States. People should drink less alcohol since the Surgeon General's advisory identified alcohol consumption as the third leading preventable cause of cancer in the United States. City of Hope doctors advise patients about this risk and also encourage patients who drink excessive amounts of alcohol to seek treatment for this.
Rikki Cannioto, PhD, EdD. Assistant Professor of Oncology in the Department of Cancer Prevention and Control at Roswell Park Comprehensive Cancer Center (Buffalo, N.Y.): Although most Americans understand that excess body weight and smoking are associated with increased cancer risk, there is a gap in public health awareness about the causal link between alcohol and cancer risk. For example, most Americans report drinking at least one alcoholic beverage each week, but less than half are aware that alcohol consumption increases risk of cancer.
As alcohol consumption is now the third-leading preventable cause of cancer behind smoking and obesity, the surgeon general's advisory on alcohol is an important step for bridging the gap in public awareness about the specific risks of alcohol. Roswell Park Comprehensive Cancer Center is dedicated to increasing awareness of this risk to clinical care teams and our patients. Warning labels can be an effective tool for sharing this important information and should reflect the most recent evidence establishing a causal relationship between alcohol consumption and risk of seven types of cancer, including breast, colorectal, esophageal, liver, mouth, throat and laryngeal.
Cindy Cen, MD. Breast Surgeon and Oncologist at Northwell Health Cancer Institute (Lake Success, N.Y.): I was really happy to see the news gaining widespread attention. The broader awareness now is encouraging because it could lead to better adherence to screening guidelines and, hopefully, a reduction in breast cancer incidence. In the short term, I think a lot of patients are going to be frantically reaching out to their doctors, asking, "How much is too much?" It's definitely becoming a bigger part of the conversation during consultations — time that might otherwise be spent on basic health history, mammogram discussions or biopsy results. At the end of the day, the goal isn't to stay busy treating more cancer; it's to prevent cancer in the first place. Someone asked me recently if alcohol warning labels would work, and I thought, well, it didn't completely stop smoking when they put labels on cigarettes. But I'm sure that, on some level, those labels made some people think twice.
Tracy Crane, PhD. Co-leader of the Cancer Control Program and Director of Lifestyle Medicine, Prevention and Digital Health at Sylvester Comprehensive Cancer Center (Miami): It may come as a surprise to many Americans that drinking any amount of alcohol is associated with an increased risk of developing several types of cancer. But through Sylvester's cancer research and what we believe is a unique lifestyle-focused approach to prevention and treatment, alcohol consumption emerges as one factor — along with diet, exercise and others — that people can modify.
Our physicians and research teams studying various cancers work collaboratively with our lifestyle medicine team and our Cancer Control Research Program, all devoted to preventing disease as well as to long-term quality of life after a cancer diagnosis. The surgeon general's report is welcome news to the oncology community. It also may ultimately be good news for Americans by raising awareness of risk factors — including alcohol consumption — something they can change to significantly reduce cancer risk.
Omer Kucuk, MD. Medical Oncologist at Winship Cancer Institute of Emory University (Atlanta): Alcohol warning labels are a strong step in the right direction. They will help highlight the fact that alcohol poses a significant public health issue. By increasing awareness, these labels can encourage people to take the risks of alcohol consumption more seriously and, hopefully, reduce their intake. We need to prioritize public education about the harmful effects of alcohol, beginning as early as elementary school and continuing through college. Additionally, more research is necessary to advance prevention strategies and deepen our understanding of alcohol's health impacts. Organizations like the NIH, NCI, CDC and ACS should consider increasing funding for alcohol-related research to support these efforts.
Daniel Nikcevich, MD,PhD. Hematologist and oncologist at Essentia Health (Duluth, Minn.): In some ways the report from the Surgeon General was not necessarily brand-new information, but rather additional data to substantiate how alcohol can be a risk factor for certain types of cancers. It has made me wonder if the increased number of colorectal cancer cases we are seeing in younger patients are potentially related to alcohol use.
This information would not necessarily directly impact clinical care in our cancer center, although it does help to inform conversations with patients about risk factor mitigation. It is not uncommon for someone who drinks alcohol regularly, but otherwise does not have other risk factors such as tobacco use, to not think that alcohol may be a cancer risk. Likewise, it is common that a patient may actually underestimate actual consumption of alcohol and therefore, not fully appreciate the cancer risk.
I believe that alcohol sold in United States does already contain a warning about health risk in general, and it seems reasonable to amend this warning to provide mention of how alcohol use may be associated with increased risk of certain cancers.